Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.20 / $128.75 / $357.77	Facility	26	$39.20	$128.75	$357.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.75 / $221.10 / $350.66	Professional		$93.75	$221.10	$350.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $92.02 / $203.12	Professional	26	$36.61	$92.02	$203.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $69.70 / $162.50	Professional	TC	$56.82	$69.70	$162.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $125.55 / $203.05	Professional		$80.91	$125.55	$203.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $77.58 / $91.32	Professional	26	$38.86	$77.58	$91.32
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $106.64 / $125.46 / $147.68	Professional	TC	$106.64	$125.46	$147.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.80 / $204.94 / $210.06	Professional		$189.80	$204.94	$210.06
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $71.43 / $77.14 / $79.06	Professional	26	$71.43	$77.14	$79.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $118.34 / $127.80 / $130.99	Professional	TC	$118.34	$127.80	$130.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $227.64 / $227.64 / $227.64	Facility	26	$227.64	$227.64	$227.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.52 / $236.53 / $319.01	Professional		$96.52	$236.53	$319.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.78 / $89.74 / $116.36	Professional	26	$37.78	$89.74	$116.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.00 / $146.80 / $202.65	Professional	TC	$61.00	$146.80	$202.65
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $95.48 / $181.68 / $181.68	Facility	26	$95.48	$181.68	$181.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $127.84 / $203.18 / $314.52	Professional		$127.84	$203.18	$314.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.77 / $78.84 / $120.02	Professional	26	$49.77	$78.84	$120.02
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.48 / $126.20 / $450.80	Professional	TC	$74.48	$126.20	$450.80
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $132.90 / $136.77 / $227.64	Facility	26	$132.90	$136.77	$227.64
Midlands Facility/Professional Professional Modifier Low / Median / High Price $136.40 / $231.29 / $294.33	Professional		$136.40	$231.29	$294.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.85 / $103.26 / $200.10	Professional		$43.85	$103.26	$200.10
United Facility/Professional Professional Modifier Low / Median / High Price $119.87 / $205.28 / $258.97	Professional		$119.87	$205.28	$258.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.77 / $79.91 / $100.81	Professional	26	$49.77	$79.91	$100.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.48 / $121.68 / $158.16	Professional	TC	$74.48	$121.68	$158.16